Median Lobe E nucleation

Plane Acquisition

Plane acquisition is a fundamental and early step that determines a smooth start of prostate enucleation.

The enucleation plane can be entered at the 5, 7, or 12 o’clock positions.
For beginners, the 5 and 7 o’clock positions are usually easier and more reproducible starting points.

At these positions, small dotted openings are often seen approximately 1 cm lateral to the verumontanum. These serve as important anatomical indicators for identifying the correct surgical plane.

The plane can be accessed using one of two techniques:

• A gentle mechanical push at this point, with the resectoscope sheath or laser/enucleation electrode directed downward and laterally, or

• A small incision at the base of the adenoma apex, about 1 cm from the verumontanum, followed by careful plane development.